Scurvy is a condition caused by a dietary lack of vitamin C (ascorbic acid), hence is also called hypovitaminosis C, and is characterized by an increased bleeding tendency and impaired collagen synthesis resulting in osteoporosis and impaired wound healing.
Scurvy in adults is rare. Young children and older persons are predisposed to scurvy due to their diet or the overheating of food. It does not occur before six months of age because maternal stores are maintained until then. Males and females are equally affected.
Patients may present with lethargy and malaise, bone pain, bleeding diathesis (e.g. bleeding gums), and impaired wound healing.
Unlike most other animals, humans cannot produce their own vitamin C.
Lack of dietary vitamin C (ascorbic acid) may be related to inadequate food intake, the destruction of vitamin C in food caused by cooking and canning, or the absence of fresh fruit in the diet.
Vitamin C is essential for collagen synthesis, acting as a coenzyme to producing cross-linking of collagen fibers. Defective collagen cross-linking compromises skin, joint, bone, and vascular integrity.
- generalized osteopenia
- cortical thinning: “pencil-point” cortex
- periosteal reaction due to subperiosteal hemorrhage
- scorbutic rosary: expansion of the costochondral junctions
- Wimberger ring sign: circular, opaque radiologic shadow surrounding epiphyseal centers of ossification, which may result from bleeding
- Frankel line: dense zone of provisional calcification
- Trümmerfeld zone: lucent metaphyseal band underlying Frankel line
- Pelkan spur: metaphyseal spurs which result in cupping of the metaphysis
Other significant manifestations in both children and adults arise from the propensity for bleeding, including intra-articular, retrobulbar, and intracranial hemorrhage.
History and etymology
The term scurvy comes from various words used to describe the manifestations of the condition: covered with scabs, diseased, scorbutic.
- scheurbuik (Dutch)
- scorbut (French)
- skybjugr (Old Norse): a swelling (bjugr) from drinking sour milk (skyr) on long sea voyages
Infantile scurvy, historically also known as Barlow disease, is named after Sir Thomas Barlow (1845-1945), Professor of Medicine at University College London 1895-1907 5.
Eugen Fraenkel (1853-1925), a German pathologist, was the first person to be appointed a full Professor of Pathology at the University of Hamburg in 1919 6,8.
Karl Francis Pelkan (1890-1992), an Austrian-American pediatrician described his eponymous spurs in a paper published in 1925 6,7.
- 1. Weissleder R, Wittenberg J, Harisinghani MG. Primer of diagnostic imaging. Mosby Inc. (2003) ISBN:0323023282. Read it at Google Books - Find it at Amazon
- 2. Robbins SL, Kumar V, Abbas AK et-al. Robbins and Cotran pathologic basis of disease. W B Saunders Co. (2010) ISBN:1437707920. Read it at Google Books - Find it at Amazon
- 3. Chapman S, Nakielny R. Aids to radiological differential diagnosis. Saunders Ltd. (2003) ISBN:0702026506. Read it at Google Books - Find it at Amazon
- 4. www.dictionary.com. Read relevant article. Accessed on 28/03/2016
- 5. Anton Sebastian. A Dictionary of the History of Medicine. (1999) ISBN: 9781850700210
- 6. Z. V. Maizlin. Wonders of Radiology. (2010) ISBN: 9781449976453
- 7. Pelkan KF. The roentgenogram in early scurvy. Am J Dis Child 1925;30(2):174-88. doi:10.1001/archpedi.1925.01920140034002.
- 8. Fraenkel E. Untersuchungen über die Möller--Barlowsche Krankheit. Fortschr Rontgenstr. 1903-4;7:231-265,291-310.
Related Radiopaedia articles
- basic organic elements
- essential bulk elements
- essential trace elements
- non-essential elements
- tumor markers
- fat-soluble vitamins
- vitamin B1 (thiamine)
- vitamin B2 (riboflavin)
- vitamin B3 (niacin)
- vitamin B5
- vitamin B6
- biotin (vitamin B7)
- vitamin B9 (folate/folic acid)
- vitamin B12
- vitamin C
- B vitamins